What You Need to Know About Controlling Anxiety Special To MD Monthly April 30, 2015 Men's, Mental Health, Women's Anxiety can cause an inner turmoil that makes your world feel like it is spinning out of control. It can be hard to know what is normal worrying, and what might be something more serious. What is Anxiety? “Anxiety is a common human condition,” says Scott & White – Round Rock Internal Medicine Physician Lianne Marks MD, PhD, FACP. Dr. Marks helps explain that evolutionarily, people anxious enough to prepare for emergencies often survived better. From there, these people were then more likely to have children and pass on the ‘anxious’ trait. When is Anxiety a Diagnosed Condition? Anxiety, however, can become a disorder when it starts interfering with effective life functioning and instead becomes harmful. Dr. Marks says this can be in any sphere of a person’s life, for example in the personal or professional realm. “I often tell patients that if they don’t find a way to deal with their excess anxieties, they will come back in another form,” says Dr. Marks. Examples of how anxiety can present itself include: Panic attacks This can occur as in bouts of overwhelming anxiety, also known as “panic attacks,” which can feel like the world is ending, the patient can feel like they can’t breathe or their heart is beating too fast. Perseveration People focus on issues outside of their sphere of influence over and over again, thereby limiting their ability to function well on the things they can influence. Psychosomatic manifestations Literally the psyche or the patient’s thinking causing abnormal body symptoms, such as insomnia or palpitations (the feeling of a fast or irregular heartbeat), and aches and pains (such as chest pain). “Anxiety becomes a clinical disorder, generalized anxiety disorder, when you manifest uncontrolled anxiety for the majority of days for at least six months, and this is adversely affecting your ability to function,” says Dr. Marks. Am I Predisposed to Have Anxiety? You can be predisposed to anxiety due to multiple factors including: Genetic factors. Lack of a nurturing environment growing up, particularly those exposed to abuse, are more likely to manifest symptoms of anxiety. Is There Any Good That Can Come From Anxiety? Many people manifest anxiety in ‘helpful’ ways, such as completing projects on time, or even channeling the energy of their anxiety into a more passionate speech, for example. “Anxiety is a common trait, including in very successful people” says Dr. Marks. Dr. Marks explains that when anxiety paralyzes you from doing things, such as public speaking, you may want to examine it closer and see if your symptoms can be improved, particularly if this impacts your ability to hold a job. Can My Anxiety Improve? Anxiety can improve with time if appropriate treatments are instituted. “First thing, is to consider if you need help,” says Dr. Marks. “If you feel at risk of hurting yourself or others, immediate help is needed.” Here are a few ways to get help for your anxiety: Exercise and meditation can be powerful when dealing with anxiety to help clear the mind. If you’re hyperventilating, try taking deep slow breaths to relax, using a technique such as square breathing — breathing in for four seconds, hold for four seconds, out for four seconds, hold for four seconds. It’ll trigger the part of your nervous system that helps you calm down, as well as changing your focus to your breathing instead of what’s making you nervous. Consult with your primary doctor as you may have something else creating anxiety like hyperthyroidism, substance abuse or other medical disorder that is making it worse. Remember to call 911 if you are having symptoms such as chest pain or sudden shortness of breath, as sometimes the symptoms of a heart attack can mimic those of a panic attack. If you find that your symptoms are affecting your ability to work or your personal relationships, you can always consider a psychiatrist or a psychotherapist. What Can I Do to Control My Anxious Thoughts? “I tell patients that if they don’t want to go for counseling, they can try journaling,” says Dr. Marks. Basically, anxiety is very similar to the feeling of powerlessness, you feel that things are bad and can’t be fixed. Journaling is one way to help deal with this. “I ask patients to start a ‘worry journal’ and limit their ‘worry time’ to a specific time per day,” says Dr. Marks. If something pops in your head, remind yourself that you’ll deal with it during your worry time, perhaps 10 minutes a day set aside. That way, the rest of the day you can be more free of concern, because you have a dedicated time to deal with it later, and you have it written down so you won’t forget. “Then when ‘worry time’ comes, you can work on your anxieties,” says Dr. Marks. She suggests during worry time write about the concerns that have come into your mind during the day. Describe them in detail, and then work next on what the plan of action should be as suggested below: You can decide whether the anxieties are outside of your sphere of influence, meaning you can spend your time worrying, but it would really be a waste of time, because you have no ability to change anything. Or, you can decide that it is inside your sphere of influence (meaning you potentially have some control over what is causing you to worry). If the latter, you can start to write down a plan of action, what can you do today, short term, and long term to improve the situation. This changes your mindset from a powerless worrying one to an empowered problem solving one. “For my patients who aren’t able or willing to do this, I usually recommend that they start counseling and/or medication to help them manage these feelings,” says Dr. Marks.